Presenting features of COVID-19 in older people: relationships with frailty, inflammation and mortality

Abstract Purpose To describe the clinical features of COVID-19 in older adults, and relate these to outcomes. Methods A cohort study of 217 individuals (median age 80, IQR 74–85 years; 62% men) hospitalised with COVID-19, followed up for all-cause mortality, was conducted. Secondary outcomes included cognitive and physical function at discharge. C-reactive protein and neutrophil:lymphocyte ratio were used as measures of immune activity. Results Cardinal COVID-19 symptoms (fever, dyspnoea, cough) were common but not universal. Inflammation on hospitalisation was lower in frail older adults. Fever, dyspnoea, delirium and inflammation were associated with mortality. Delirium at presentation was an independent risk factor for cognitive decline at discharge. Conclusions COVID-19 may present without cardinal symptoms as well as implicate a possible role for age-related changes in immunity in mediating the relationship between frailty and mortality.

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Presenting features of COVID-19 in older people: relationships with frailty, inflammation and mortality

10.1101/2020.06.07.20120527 ◽

2020 ◽

Cited By ~ 1

Author(s):

Paul Knopp ◽

Amy Miles ◽

Thomas E Webb ◽

Benjamin C Mcloughlin ◽

Imran Mannan ◽

...

Keyword(s):

Older Adults ◽

Older Individuals ◽

C Reactive Protein ◽

Immune Activity ◽

Neutrophil Lymphocyte Ratio ◽

Reactive Protein ◽

Age Related ◽

Cardinal Symptoms ◽

The Relationship ◽

Age Related Changes

AbstractPurposeTo describe the clinical features of COVID-19 in older adults, and relate these to outcomes.MethodsCohort study of 217 individuals (≥70 years) hospitalised with COVID-19, followed up for allcause mortality. Secondary outcomes included cognitive and physical function at discharge. C-reactive protein and neutrophil: lymphocyte ratio were used as measures of immune activity.ResultsCardinal COVID-19 symptoms (fever, dyspnoea, cough) were common but not universal. Inflammation on hospitalisation was lower in frail older adults. Fever, dyspnoea, delirium and inflammation were associated with mortality. Delirium at presentation was an independent risk factor for cognitive decline at discharge.ConclusionsCOVID-19 may present without cardinal symptoms as well as implicate a possible role for age-related changes in immunity in mediating the relationship between frailty and mortality.Key summary pointsAimTo characterise symptoms, key findings and clinical outcomes in older adults with COVID-19Findings12% of older individuals did not present with classical COVID-19 symptoms, though fever, dyspnoea, delirium and raised inflammation were associated with higher mortality. Compared with fitter older individuals, immune activity was lower in frailer patients.MessageCOVID-19 may present without cardinal symptoms as well as implicate a possible role for age-related changes in immunity in mediating the relationship between frailty and mortality.

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Auditory word recognition across the lifespan

Linguistic Approaches to Bilingualism ◽

10.1075/lab.14030.blu ◽

2016 ◽

Vol 6 (1-2) ◽

pp. 119-146 ◽

Cited By ~ 12

Author(s):

Henrike K. Blumenfeld ◽

Scott R. Schroeder ◽

Susan C. Bobb ◽

Max R. Freeman ◽

Viorica Marian

Keyword(s):

Older Adults ◽

Cognitive Control ◽

Cognitive Processes ◽

Processing Speed ◽

Word Identification ◽

Age Related ◽

Auditory Word ◽

Auditory Word Recognition ◽

The Relationship ◽

Age Related Changes

Abstract Recent research suggests that bilingual experience reconfigures linguistic and nonlinguistic cognitive processes. We examined the relationship between linguistic competition resolution and nonlinguistic cognitive control in younger and older adults who were either bilingual or monolingual. Participants heard words in English and identified the referent among four pictures while eye-movements were recorded. Target pictures (e.g., cab) appeared with a phonological competitor picture (e.g., cat) and two filler pictures. After each eye-tracking trial, priming probes assessed residual activation and inhibition of target and competitor words. When accounting for processing speed, results revealed that age-related changes in activation and inhibition are smaller in bilinguals than in monolinguals. Moreover, younger and older bilinguals, but not monolinguals, recruited similar inhibition mechanisms during word identification and during a nonlinguistic Stroop task. Results suggest that, during lexical access, bilinguals show more consistent competition resolution and recruitment of cognitive control across the lifespan than monolinguals.

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Sex differences in the relationship between obesity, C-reactive protein, physical activity, depression, sleep quality and fatigue in older adults

Brain Behavior and Immunity ◽

10.1016/j.bbi.2008.12.003 ◽

2009 ◽

Vol 23 (5) ◽

pp. 643-648 ◽

Cited By ~ 37

Author(s):

Rudy J. Valentine ◽

Edward McAuley ◽

Victoria J. Vieira ◽

Tracy Baynard ◽

Liang Hu ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sex Differences ◽

Sleep Quality ◽

C Reactive Protein ◽

Reactive Protein ◽

The Relationship

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Age-Related Differences in the Association between Plasma High-Sensitivity C-Reactive Protein and Noncalcified or Mixed Coronary Atherosclerotic Plaques

Mediators of Inflammation ◽

10.1155/2020/5938957 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Tiewei Li ◽

Ning Chen ◽

Zhengan Liu ◽

Zhiming Shan ◽

Geng Dong ◽

...

Keyword(s):

Older Adults ◽

Multiple Logistic Regression Analysis ◽

Laboratory Data ◽

High Sensitivity ◽

Coronary Plaque ◽

Control Group ◽

C Reactive Protein ◽

Old Adults ◽

Reactive Protein ◽

Age Related

Background. Previous studies have demonstrated that plasma high-sensitivity C-reactive protein (hsCRP) was the predictor for unstable coronary plaque. Patients with noncalcified plaque (NCP) or mixed plaque (MP) have a higher risk of poor outcomes. However, the association between hsCRP and the presence of NCP or MP (NCP/MP) in old adults remains unclear, and if present, whether there exist differences between young and old adults remain unknown. Thus, the aim of this study was to investigate the role of hsCRP in predicting the presence of NCP/MP and evaluate whether age has any impact on this association. Methods. A total of 951 subjects were included in this study. Complete clinical and laboratory data were collected. According to the characteristics of the most stenotic plaque, we divided them into 2 groups: calcified plaque (CP) and NCP/MP. Subjects with no plaque were classified as the control group (CR). Subjects with age≥60 years were defined as older adults, and those with age<60 years were classified as nonelderly people. Results. Patients with NCP/MP had significantly higher hsCRP level compared with subjects with CR or CP in older adults but not in nonelderly people. The proportion of NCP/MP was significantly increased from 27.0% in the hsCRP<1.25 mg/L group to 42.7% in the hsCRP>2.70 mg/L group in older adults. Multiple logistic regression analysis showed that hsCRP was an independent risk factor for the presence of NCP/MP (odds ratio OR=1.093, 95% CI 1.032–1.157, P=0.001) only in older adults. Conclusions. hsCRP is independently associated with the presence of NCP/MP in older adults but not in nonelderly people. These results suggest the potential significance of hsCRP-lowering regimens in older adults with NCP/MP.

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Interactions between C-reactive protein and traditional risk factors in predicting mortality of older adults

VASA ◽

10.1024/0301-1526/a000599 ◽

2017 ◽

Vol 46 (2) ◽

pp. 127-133 ◽

Cited By ~ 3

Author(s):

Henrik Rudolf ◽

Naemi Wall ◽

Renate Klaassen-Mielke ◽

Ulrich Thiem ◽

Curt Diehm ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Older Adults ◽

Body Mass Index ◽

Body Mass ◽

Hazard Ratio ◽

C Reactive Protein ◽

Reactive Protein ◽

All Cause Mortality ◽

High Level

Abstract. Background: Elevated levels of C-reactive protein (CRP) are known to be associated with cardiovascular (CV) morbidity and mortality in older adults, however, there seems to be heterogeneity of this association across subsets of individuals. We aim to assess the effects of interactions between CRP and one of the following traditional CV risk factors regarding all-cause mortality in unselected elderly men and women: age, sex, body mass index, diabetes, and hypertension. Patients and methods: Three hundred and forty-four general practitioners all over Germany enrolled 6,817 unselected participants, aged 65 years or older, and performed thorough examinations, including CRP measurement at baseline (getABI study). All-cause mortality was determined in the following seven years. Cox regression analyses were done using uni- and multivariable models. Results: At baseline 4,172 participants of this cohort had a CRP value of ≤ 3 mg/L (low level CRP group), 2,645 participants had a CRP value of > 3 mg/L (high level CRP group). The unadjusted hazard ratio for all-cause death of the high level CRP group compared to the low level CRP group was 1.49 (95 % confidence interval [95 %CI] 1.34 to 1.66). After adjustment for sex, age, education, peripheral artery disease/media sclerosis, other prior vascular events, smoking status, diabetes, systolic blood pressure, antihypertensive medication, body mass index, cholesterol, and statin use, the hazard ratio was 1.34 (95 %CI 1.20 to 1.50). Significant interactions with CRP were found for sex (adjusted hazard ratio 1.38, 95 %CI 1.11 to 1.72), age (0.75, 95 %CI 0.60 to 0.94), and baseline systolic blood pressure (0.64, 95 % CI 0.51 to 0.81). The interactions of CRP with body mass index and of CRP with diabetes were not significant. Conclusions: In older German adults, there seem to be effect modifications by age, sex, and arterial hypertension regarding the effect of CRP in the prediction of all-cause mortality.

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Fear and C-reactive protein cosynergize annual pulse increases in healthy adults

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1418264112 ◽

2014 ◽

Vol 112 (5) ◽

pp. E467-E471 ◽

Cited By ~ 27

Author(s):

Shani Shenhar-Tsarfaty ◽

Nadav Yayon ◽

Nir Waiskopf ◽

Itzhak Shapira ◽

Sharon Toker ◽

...

Keyword(s):

Health Risks ◽

Hierarchical Regression ◽

C Reactive Protein ◽

Partial Least Squares Analysis ◽

Inflammatory Biomarker ◽

Reactive Protein ◽

Exposed Population ◽

Age Related ◽

All Cause Mortality

Recent international terror outbreaks notably involve long-term mental health risks to the exposed population, but whether physical health risks are also anticipated has remained unknown. Here, we report fear of terror-induced annual increases in resting heart rate (pulse), a notable risk factor of all-cause mortality. Partial least squares analysis based on 325 measured parameters successfully predicted annual pulse increases, inverse to the expected age-related pulse decline, in approximately 4.1% of a cohort of 17,380 apparently healthy active Israeli adults. Nonbiased hierarchical regression analysis among 27 of those parameters identified pertinent fear of terror combined with the inflammatory biomarker C-reactive protein as prominent coregulators of the observed annual pulse increases. In comparison, basal pulse primarily depended on general physiological parameters and reduced cholinergic control over anxiety and inflammation, together indicating that consistent exposure to terror threats ignites fear-induced exacerbation of preexisting neuro-immune risks of all-cause mortality.

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Major Discrimination, Race-Ethnicity, and Inflammation Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.1326 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 344-344

Author(s):

Lauren Parker ◽

Roland Thorpe ◽

Ryon Cobb

Keyword(s):

Older Adults ◽

High Risk ◽

Prevalence Ratio ◽

C Reactive Protein ◽

Reactive Protein ◽

Race Ethnicity ◽

The Relationship ◽

Prevalence Ratios ◽

Retirement Study ◽

Ethnicity Data

Abstract This study examines the relationship between self-reported instances of major discrimination and inflammation among older adults, and explores whether this relationship varies in accordance with race/ethnicity. Data from 2006/2008 Health and Retirement Study was used to collect measures of self-reported instances of major discrimination and high-risk C-reactive protein (CRP), which was assayed from blood samples. Modified Poisson regression with robust standard errors was applied to estimate the prevalence ratios of self-reported instances of major discrimination, as it relates to high-risk CRP (CRP ≥ 22 kg/m2), and test whether this relationship varies by race/ethnicity. Respondents who experienced any instances of major discrimination had a higher likelihood of high-risk CRP (prevalence ratio [PR]: 1.14, 95% confidence interval [CI] = 1.07–1.22) than those who did not report experiencing any instances of major discrimination. This relationship was weaker for blacks than whites (PR: 0.81, 95% CI = 0.69–0.95).

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Abstract P224: Does Cognitive Function And C-reactive Protein Produce A Combined Effect On All-cause Mortality Risk? An Analysis Of Older Adults In The 1999-2002 NHANES

Circulation ◽

10.1161/circ.143.suppl_1.p224 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Madeline B Zipperer ◽

James R Churilla ◽

Michael R Richardson

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Mortality Risk ◽

Representative Sample ◽

Combined Effects ◽

C Reactive Protein ◽

Reactive Protein ◽

High Cognitive Function ◽

All Cause Mortality ◽

Nationally Representative

Introduction: There is limited evidence examining the combined effects of cognitive function and C-reactive protein (CRP) on mortality risk using a large nationally representative sample of U.S. adults. Hypothesis: We assessed the hypothesis that cognitive function and CRP produce a combined effect in predicting all-cause mortality risk. Objective: Examine the combined effects of cognitive function and CRP in predicting all-cause mortality in a large nationally representative sample of U.S. adults. Methods: The study sample (n=2,111) included older adults (≥ 60 years of age) who participated in the 1999-2002 National Health and Nutrition Examination Survey. A four-level variable was created based on CRP concentration and cognitive function (high cognitive function and low to average CRP; high cognitive function and high CRP; low cognitive function and low to average CRP; low cognitive function and high CRP). Results: Compared to a referent group with low to average CRP and high cognitive function, analysis revealed a statistically significant increase in risk of all-cause mortality in adults with high CRP and low cognitive function (Hazards Ratio [HR] 1.97; 95% Confidence Interval [CI], 1.52-2.55, p<0.0001) and in adults with low to average CRP and low cognitive function (HR 1.76; 95% CI, 1.44-2.15, p<0.0001). Similar relationships were not revealed in adults with high cognitive function, regardless of CRP concentration. Conclusions: In a large nationally representative sample of older U.S. adults, low cognitive function was associated with increased all-cause mortality risk independent of CRP concentration.

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Activity Engagement and Cognitive Performance Amongst Older Adults

Frontiers in Psychology ◽

10.3389/fpsyg.2021.620867 ◽

2021 ◽

Vol 12 ◽

Author(s):

Alexandria N. Weaver ◽

Susanne M. Jaeggi

Keyword(s):

Older Adults ◽

Cognitive Performance ◽

Cognitive Reserve ◽

Mental Functioning ◽

Activity Engagement ◽

Healthy Older Adults ◽

Age Related ◽

Cognitive Activities ◽

The Relationship ◽

Age Related Changes

Research supporting cognitive reserve theory suggests that engaging in a variety of cognitive, social, and physical activities may serve as protective factors against age-related changes in mental functioning, especially if the activities are cognitively engaging. Individuals who participate in a variety of cognitive activities have been found to be more likely to maintain a higher level of cognitive functioning and be less likely to develop dementia. In this study, we explore the relationship between engaging in a variety of activities and cognitive performance amongst 206 healthy older adults between the ages of 65–85. Age and years of education were found to be the most significant predictors of a global composite representing cognitive performance, consistent with previous work linking these variables to age-related changes in cognition and the cognitive reserve. We interpret these results to suggest that age and education are better predictors of global cognitive performance in older adults than self-reported activity engagement.

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